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ABG acute v chronic resp acidosis?

You are asked to review a 63-year-old female who was admitted with shortness of breath. On your arrival, the patient appears drowsy and is on 10L of oxygen via a face mask. You perform an ABG which reveals the following results:
PaO2: 7.0 kPa (53 mmHg)
pH: 7.29
PaCO2: 9.1 kPa (68 mmHg)
HCO3-: 26 mmol/L
Base excess: +1

What does the ABG show?

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Final answer:

The ABG shows a case of respiratory acidosis, with the pH below normal and an elevated PaCO2, indicating acidosis with a respiratory cause. There is a slight sign of compensation through a bit higher HCO3- and base excess, however, the levels are not fully compensated, likely indicating an acute condition.

Step-by-step explanation:

The provided Arterial Blood Gas (ABG) results indicate that the patient is in respiratory acidosis. This condition occurs when there is an excess of CO₂ in the blood, leading to a decrease in the pH level. The patient's pH is 7.29, which is below the normal range of 7.35-7.45 and confirms acidosis. The PaCO₂ level is elevated at 9.1 kPa (68 mmHg), indicating the respiratory component of the acidosis. Additionally, the HCO₃− level is within the normal range of 22-29 mM, and the base excess is slightly positive (+1), which may suggest a beginning of a compensatory response, where the kidneys attempt to produce and retain bicarbonate to compensate for the high levels of carbon dioxide.

However, the normal level of HCO₃− signifies that the compensation has not fully developed, which may suggest that the condition is more acute rather than a well-compensated chronic state. Over time, with chronic respiratory acidosis, one would expect to see a higher HCO₃− level due to renal compensation.

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